In the fall of 2006 it was revealed that Farrah Fawcett was suffering from anal cancer. A spokesman for the actress had said she was undergoing treatment that involved radiation and chemotherapy, but not surgical removal of the tumor. Four months after this initial disclosure, press reports declared the actress was cancer free.

Sadly, less than four months later in May of 2007, it was disclosed that the cancer had recurred in the area where she had previously received treatment. We subsequently learned that distant metastatic disease was found in the liver.

Fawcett then decided to travel to Germany for treatment which included surgery for the tumor and other undisclosed therapies, possibly including embolization of metastatic tumors in the liver. The latter involves threading a catheter into the blood supply of the tumor and injecting filler to cut off blood flow to the tumor. This was combined with additional chemotherapy back in the States. After signs of initial response to these interventions, recurrence led to yet more treatment.

The actress has required multiple hospital admissions during 2009, the subject of much speculation and publicity. Other than supportive care, it’s not clear what, if any, additional therapy Fawcett is undergoing for her metastatic anal cancer.

Anal cancer is really uncommon in the U.S. In 2008, around 5000 adults were diagnosed with the disease, leading to nearly 700 deaths. This compares to 215,000 new cases of lung cancer with 160,000 deaths and more than 180,000 cases of breast cancer with over 40,000 deaths.

Overall survival rates for anal cancer are 61% for men and 73% for women. Detected early, patients with anal cancer have an 82% five-year survival rate. For those with metastatic disease, as in Fawcett’s case, five-year survival is only 19% from the time of initial diagnosis.

Most anal cancers occur in people between 50 and 80, so routine inspection and digital examination is an important screening tool in this population. The human papillomavirus (HPV) is implicated in up to 85% of all anal cancers.

Because of the association of this cancer with HPV, risk factors include having many sexual partners and having receptive anal intercourse. And barrier methods do not afford complete protection as the virus can be transmitted from nearby uncovered skin areas. HPV vaccine, which is being used to prevent cervical cancers, is not yet approved for prevention of anal cancers, although clinical trials are ongoing.

Other risk factors include being over 50, having a weakened immune system, frequent anal redness and soreness, and smoking.

Since early diagnosis is vital, it is important that you visit your doctor is you note any of the following signs or symptoms:

Bleeding from the anal area (don’t just assume this is from hemorrhoids)